Abstract für Schweizerischen Sportmedizin Kongress SGSM, Congrès
Suisse de Médecine du Sport SSMS, Lausanne, 18.-20.05.00
G. Jimmy 1 , D. Furler, B.W. Martin 1 , B. Marti 1
1 Sportwissenschaftliches Institut, Bundesamt für Sport, Magglingen
"Vom Rat zur Tat", Machbarkeitsstudie zur qualifizierten Bewegungsberatung in
Arztpraxen
Einleitung: Die Bedeutung von körperlicher Aktivität für die Gesundheit wird durch eine
Vielfalt von Studien eindrücklich bestätigt. Daten aus der Schweiz zeigen, dass mindestens
ein Drittel der Bevölkerung die Mindestempfehlungen für gesundheitsfördernde Bewegung
nicht erfüllt. In mehreren Studien ist die Empfehlung des Arztes die häufigst genannte
Bedingung, unter welcher Inaktive beginnen würden, sich zu bewegen. Das Ziel der
vorliegenden Studie war, im Hinblick auf eine Wirksamkeitsstudie Erfahrungen über ein auf
Arztpraxen gestütztes Beratungs- und Remindersystems zu sammeln. Methode: Im Herbst
1999 wurde in vier Grundversorgerpraxen während je 2 Wochen ein auf dem
Transtheoretischen Modell basierender Fragebogen zum Bewegungsverhalten an einen Teil
der Patienten in der Sprechstunde verteilt. Aufgrund dessen nahm der Arzt eine Beurteilung
des Bewegungsverhaltens vor und empfahl bei Bedarf eine umfassendere Beratung bei einer
Bewegungsfachperson. In dieser wurde das Bewegungsverhalten unter Berücksichtigung
psychosozialer Aspekte genauer analysiert und eine Zielsetzung ausgearbeitet. Telefonische
Nachbefragungen wurden nach 6-8 Wochen durchgeführt. Resultate: Von 166 Personen
stuften sich 61 (37%) als zu wenig aktiv ein. Deren 40 wurden in die Interventionsgruppe
randomisiert. Von 36 Interventionspersonen und 18 Kontrollen liegen vollständige Daten vor.
21 Interventionspersonen nahmen an der umfassenderen Beratung teil, deren 12 (57.1%)
wiesen nach der Intervention keinen Bewegungsmangel mehr auf; ebenso 7 (46.7%) der
weiteren Interventionspersonen. Bei den Kontrollen stuften sich 3 (16.7%) in der
Nachbefragung als genügend aktiv ein. Das gewählte Modell erwies sich als gut durchführbar
und wurde sowohl von Ärzte- als auch Patientenseite her positiv aufgenommen.
Schlussfolgerung: Personen mit Bewegungsmangel sprechen gut auf entsprechende
Empfehlungen des Arztes an. Das gewählte Beratungsmodell der Zusammenarbeit zwischen
Arzt und Bewegungsfachperson hat sich bewährt. Sein Potential soll in einer Studie mit
genügenden Fallzahlen evaluiert werden.
Korrespondenzadresse:
Gerda Jimmy, Sportwissenschaftliches Institut, Bundesamt für Sport, 2532 Magglingen,
gerda.jimmy@baspo.admin.chG. Jimmy, B. W. Martin, B. Marti
Institute of Sports Sciences, Federal Office of Sports, Magglingen, Switzerland
„Active upon advice“: experiences from primary care office based physical
activity promotion in Switzerland
Introduction: An increasing wealth of literature underpins the importance of physical
activity for our health. In a national survey conducted in 1999, 37% of the population
living in Switzerland reported not meeting the recommendations for physical activity,
leaving a remarkable potential for increase. In motivation studies, inactive people most
often stated the advice of their physician to be the one incentive which would help them
become more active. The aim of “active upon advice” was to help people adopt an
active lifestyle based on an intervention at the primary care office.
Methods: In a randomised controlled trial, questionnaires were handed out to the
patients entering one of the 5 primary care offices in suburban areas of Zurich taking
part in the project. Inactive people were selected as subjects based on their stage of
change for moderate physical activity according to the questionnaire. Individuals in the
intervention group were encouraged by their physician to increase their physical activity
level and received a stage specific leaflet. In addition, physicians recommended an
individual physical activity counselling session. Controls were merely given feedback on
their current level of physical activity by their physician. General participation and factors
influencing a person’s choice to take part in the individual counselling session were
included in the process evaluation. The impact was measured after 6- 8 weeks in terms
of meeting the recommendation for health enhancing physical activity and in terms of
self- estimation of improvement. For the long- term outcome evaluation, subjects were
questioned again in summer 2001.
Results: Of the 572 eligible patients, 90% filled in a questionnaire. 178 (35%) were
classified as inactive of which 161 people agreed to be questioned at follow- up and were
thus entered in the study. Follow- up rates for intervention and control subjects were 94%
and 92% respectively, resulting in complete data for 65 intervention and 85 control
people.
The individual counselling session was attended by 38% of the intervention people.
While stage of change at baseline did not appear to influence a person’s decision to
participate in counselling, there was a great variety in participation according to the
primary care office attended. Furthermore, women were more likely to take part than
men. There was no significant difference between the mean age of participants and non-
participants. However, differences were seen for the age distribution. 38% of the inactive
individuals in the intervention group were classified as active at follow- up, filling in a
questionnaire and receiving feedback from the physician alone increased activity nearly
as much in the short run (35%). However, significant differences between the
intervention and control group were found for the self- estimation of improvement (43%,
19%).
Conclusion: The vast majority of patients were willing to accept opportunistic advise on
physical activity from their physician and to take part in the counselling session. The
short- term impact results were encouraging. Outcome results after 12 months will
provide more insight into the long- term effects of the programme and the differences
between intervention and control group.
Abstract submitted for a poster presentation at the
69 e Assemblée Annuelle de la Société Suisse de Médecine Interne
ainsi que les réunions annuelles de la Société Suisse d’Hématologie, Société Professionnelle
Suisse de Gériatrie, Section de Pharmacologie et Toxicologie Clinique, Société Suisse
d’Infectiologie, Société Suisse de Médecine et de Soins Palliatifs, Association Suisse pour la
Santé des Adolescents et Société Suisse de Santé Publique
Palais de Beaulieu, Lausanne10–12 mai 2001
G. Jimmy, B.W. Martin, B. Marti
Institute of Sports Sciences FOSPO, Magglingen, Switzerland
„Active upon advice“: The potential of primary care office based physical activity
promotion
Introduction:
An increasing wealth of literature underpins the importance of physical activity for our health.
In a national survey conducted in 1999, 37% of the population living in Switzerland reported
not meeting the recommendations for physical activity, leaving a remarkable potential for
increase. In motivation studies, inactive people most often stated the advice of their
physician to be the one incentive which would help them become more active. The aim of
“active upon advice” was to help people adopt an active lifestyle based on intervention at the
primary care office.
Methods:
In a randomised controlled trial, questionnaires were handed out to the patients entering one
of the 5 primary care offices in suburban areas of Zurich taking part in the project. Inactive
people were selected as subjects based on their stage of change for moderate physical
activity according to the questionnaire. Individuals in the intervention group were encouraged
by their physician to increase their physical activity level and received a stage specific leaflet.
In addition, physicians recommended an individual physical activity counselling session.
Controls were merely given feedback on their current level of physical activity by their
physician. General participation and factors influencing a person’s choice to take part in the
individual counselling session were included in the process evaluation. The impact was
measured after 6-8 weeks in terms of meeting the recommendation for health enhancing
physical activity and in terms of self-estimation of improvement. For the long-term outcome
evaluation, subjects will be questioned again after 12 months.
Results:
Of the 572 eligible patients, 90% filled in a questionnaire. 178 (35%) were classified as
inactive of which 161 people agreed to be questioned at follow-up and were thus entered in
the study. Follow-up rates for intervention and control subjects were 94% and 92%
respectively, resulting in complete data for 65 intervention and 85 control people.
The individual counselling session was attended by 38% of the intervention people. While
age and stage of change at baseline did not appear to influence a person’s decision to
participate in counselling, there was a great variety in participation according to the primary
care office attended. Furthermore, women were more likely to take part than men.
38% of the inactive individuals in the intervention group were classified as active at follow-up,
filling in a questionnaire and receiving feedback from the physician alone increased activity
nearly as much(35%). However, significant differences between the intervention and control
group were found for the self-estimation of improvement (43%, 19%)
Conclusion:
The vast majority of patients were willing to accept opportunistic advise on physical activity
from their physician and to take part in the counselling session. The intervention appears to
have a great impact on patients’ physical activity behaviour, at least in the short term
physician’s advise alone seems to have a considerable effect.
Correspondance to:
Brian Martin, Sportwissenschaftliches Institut, Bundesamt für Sport, 2532 Magglingen
brian.martin@baspo.admin.ch
