Behavioral Interventions to Modify Physical Activity

The Agency for Healthcare Research and Quality (AHRQ) has released a new report on programs to increase exercise among Americans. “Effectiveness of Behavioral Interventions to Modify Physical Activity Behaviors in General Populations and Cancer Patients and Survivors” is available online at http://www.ahrq.gov/clinic/epcsums/pacansum.htm.

According to the latest statistics, 70 percent of adults in the United States do not get enough physical activity, and more than one third of children do not participate regularly in vigorous exercise. A study released by the Centers for Disease Control and Prevention in March 2004 found that 400,000 deaths in the United States are linked to poor diet and lack of physical activity annually, which is an increase of 33 percent since 1990.

The AHRQ’s evidence review found that no specific behavioral intervention or setting appeared to be more effective than another and that shorter, less-intensive programs were just as successful at achieving behavior change as ones that lasted longer and involved more contacts with participants.

Interventions examined included face-to-face counseling, mailings, and check-ups by telephone. Settings for the interventions included clinics, community centers, schools, workplaces, child care centers, exercise centers, churches, and participants’ homes.

Some behavior-modification programs designed to increase exercise show continued effects for at least three months after they end. However, the review of existing evidence also demonstrated that it is difficult to achieve sustainable gains in increased physical activity because few studies looked at the effects of these programs for more than one year.

In addition to reviewing evidence from physical activity interventions in healthy populations, the authors examined the effects of exercise on cancer survivors. The report concluded that exercise programs can improve cancer patients’ functional capacity and cardiopulmonary fitness, reduce symptoms of fatigue, and improve quality of life during and after cancer treatment. In addition, exercise can reduce cancer patients’ symptoms of anxiety and depression during treatment. The report suggests that physical activity may have other positive effects among cancer patients, but at this time there are too few studies to reach any conclusions.

According to the AHRQ, the report provides good information about increasing physical activity through interventions delivered in a variety of settings, and it hopes the report will help to identify programs that can lead to sustained behavior change.