Prevalence and temporal trends of physical activity counselling in primary health care in Germany from 1997-1999 to 2008-2011.

Lars Gabrys,Martin Schlaud,Susanne Jordan

doi:10.1186/s12966-015-0299-9

Abstract

BackgroundFor patients, usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year. Therefore, physical activity counselling strategies delivered by a physician seem to be a promising approach for physical activity improvement. The aim of this work is to show prevalence and time trends in physical activity counselling by primary health care physicians from 1997–1999 to 2008–2011 in Germany.MethodsData from two representative cross-sectional health interview and examination surveys of the Robert Koch Institute were used. Prevalence proportions of physicians’ physical activity counselling and patients’ utilisation of health promotion programmes in relation to physical activity counselling were analysed. Strengths of associations were calculated by using binary logistic regression models. Overall, 11,907 persons aged 18–64 years were included in the analyses.ResultsPhysical activity counselling prevalence decreased from 11.1 to 9.4 % in men and from 9.3 to 7.7 % in women over ten years. Only persons with accumulated health risks (OR 5.33; 95 % CI 1.89–15.00) and persons with diagnosed diabetes mellitus (OR 3.42; 95 % CI 1.68–6.69) showed significantly higher counselling proportions in 2008–2011 compared to 1997–1999. Men were more often counselled on physical activity than women, but women showed significantly higher participation rates in physical activity promotion programmes in both surveys. In both sexes significantly higher participation rates could be observed in persons who had received some activity counselling by a physician.ConclusionAlthough, evidence underlines the positive health effects of regular physical activity; overall, physicians counselling behaviour on physical activity decreased over time. However, it is positive to note that a trend towards a disease-specific counselling behaviour in terms of a tailored intervention could be observed.

Highlights

Usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year
The analyses showed slightly but not significantly higher physical activity counselling proportions in men compared to women in almost all age groups (Fig. 1)
Apart from overall low counselling rates provided by primary health care physicians, our results show that patient’s participation in physical activity promotion programmes increased significantly from 1997–1999 to 2008–2011 and is almost doubled in both sexes in the later survey period

Summary

Introduction

Usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year. Physical activity counselling strategies delivered by a physician seem to be a promising approach for physical activity improvement. In 2013, Joy et al published an article entitled physical activity counselling in sports medicine: a call to action [1] Therein they stated the enormous potential of physical activity for the prevention and management of most chronic non-communicable diseases (NCDs), and as they call it the ethical and legal obligation of physicians to encourage and help their patients to be more physically active. Physical activity counselling strategies delivered by physicians seem to be a promising public health approach for physical activity improvements on a population-wide level. Barnes et al [15] showed time trends from 2000 to 2010 of physical activity counselling rates in the U.S They reported an overall increase of about 10 % in U.S adults who had received physician’s or other health professional’s advice to exercise or other physical activity in the last 12 months [15]

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